By simulating the exam environment, NCLEX RN Practice Questions help students develop the necessary stamina and concentration for the actual test.
NCLEX Nervous System Diseases Questions - NCLEX Questions on Nervous System Diseases
Nervous System Diseases NCLEX Practice Questions
Question 1.
A 58-year-old male patient was admitted to the emergency department with complaints of difficulty breathing and altered mental status. The patient was found to have irregular breathing patterns, with pauses at the end of inspiration and expiration. The patient also had difficulty speaking and was disoriented. A neurological examination revealed a dysfunction in the middle or caudal pons.
Which of the following statements from the patient indicates that the patient is experiencing Apneustic breathing?
(a) "My breathing feels very regular and fast."
(b) "I feel like my breathing is totally irregular."
(c) "I have clusters of breaths with pauses in between."
(d) "My breathing feels very shallow and slow."
(e) "I have rhythmic breathing patterns with periods of apnea."
(f) "I have sustained, deep breaths without pauses."
(g) "I have difficulty breathing and speaking."
(h) "I have disorientation and altered mental status."
Answer:
(a) "My breathing feels very regular and fast."
(b) "I feel like my breathing is totally irregular."
(c) "I have clusters of breaths with pauses in between."
Explanation:
The patient is experiencing apneustic breathing, which is characterized by irregular respirations, with pauses at the end of inspiration and expiration, indicating a dysfunction in the middle or caudal pons. Option (a) is incorrect because it describes neurogenic hyperventilation, which is characterized by regular, rapid, and deep sustained respirations. Option (b) is correct because it describes ataxic breathing, which is characterized by totally irregular breathing patterns.
Option (c) is correct because it describes cluster breathing, which is characterized by clusters of breaths with irregularly spaced pauses. Option (d) is incorrect because it describes hypoventilation, which is characterized by shallow and slow breathing. Option (e) is incorrect because it describes Cheyne-Stokes breathing, which is characterized by rhythmic breathing patterns with periods of apnea, indicating a metabolic dysfunction or dysfunction in the cerebral hemisphere or basal ganglia.
Option (f) is incorrect because it describes hyperpnea, which is characterized by sustained, deep breaths without pauses. Option (g) and (h) are irrelevant to the breathing pattern of the patient and the neurological examination findings.
Question 2.
Which of the following statements from the nurse indicates that they understand the significance of the Babinski reflex?
(a) "The Babinski reflex is a normal reflex in adults."
(b) "The Babinski reflex is elicited by touching the back of the throat."
(c) "The Babinski reflex indicates a dysfunction of cranial nerve V."
(d) "The Babinski reflex is elicited by firmly stroking the lateral aspect of the sole of the foot."
(e) "The Babinski reflex is a sign of a healthy central nervous system."
(f) "The Babinski reflex is a sign of dysfunction of cranial nerves IX and X."
(g) "The Babinski reflex is only present in infants."
(h) "The Babinski refl ex is a sign of peripheral nervous system disease."
Answer:
(d) "The Babinski reflex is elicited by firmly stroking the lateral aspect of the sole of the foot."
(h) "The Babinski refl ex is a sign of peripheral nervous system disease."
(e) "The Babinski reflex is a sign of a healthy central nervous system."
Explanation:
Option (a) is incorrect because the Babinski reflex is not normal in adults. Option (b) is incorrect because the reflex being referred to in the statement is actually the Gag reflex, not the Babinski reflex. Option (c) is incorrect because the Babinski reflex indicates a dysfunction of the central nervous system, not cranial nerve V. Option (d) is correct because this is an accurate statement about how to elicit the Babinski reflex.
Option (e) is correct because the Babinski reflex is indeed a sign of a healthy central nervous system in infants. Option (f) is incorrect because the reflex being referred to in the statement is actually the Gag reflex, not the Babinski reflex. Option (g) is incorrect because the Babinski reflex can also be present in adults with certain central nervous system disorders. Option (h) is correct because the Babinski reflex is a sign of peripheral nervous system disease.
Question 3.
Which of the following statements from the nurse indicates that they are correctly assessing and monitoring the unconscious client's respiratory and circulatory status?
(a) "I will assess lung sounds for the presence of edema"
(b) "I will monitor for constipation and impaction"
(c) "I will maintain NPO status until consciousness returns"
(d) "I will assess neurological status using a coma scale"
(e) "I will initiate measures to prevent skin breakdown"
(f) "I will provide range-of-motion exercises to prevent contractures"
(g) "I will use side rails unless contraindicated or according to agency protocol"
(h) "I will avoid Trendelenburg position"
Answer:
(a) "I will assess lung sounds for the presence of edema"
(h) "I will avoid Trendelenburg position"
(d) "I will assess neurological status using a coma scale"
Explanation:
Option (a) ("I will assess lung sounds for the presence of edema") is incorrect because edema is not typically associated with lung sounds. The nurse should assess lung sounds for the accumulation of secretions and suction as needed, which is mentioned in the passage.
Option (b) ("I will monitor for constipation and impaction") is incorrect because although important, it does not relate to the assessment and monitoring of the unconscious client's respiratory and circulatory status.
Option (c) ("I will maintain NPO status until consciousness returns") is incorrect because it pertains to the client's nutrition status rather than respiratory and circulatory status.
Option (d) ("I will assess neurological status using a coma scale") is correct because assessing neurological status is important in monitoring the client's respiratory and circulatory status. The coma scale assesses level of consciousness, which can be an indicator of the client's overall condition.
Option (e) ("I will initiate measures to prevent skin breakdown") is incorrect because it does not relate to the assessment and monitoring of the unconscious client's respiratory and circulatory status.
Option (f) ("I will provide range-of-motion exercises to prevent contractures") is incorrect because it does not relate to the assessment and monitoring of the unconscious client's respiratory and circulatory status.
Option (g) ("I will use side rails unless contraindicated or according to agency protocol") is incorrect because although important, it does not relate to the assessment and monitoring of the unconscious client's respiratory and circulatory status.
Option (h) ("I will avoid Trendelenburg position") is correct because the Trendelenburg position (head down, feet up) can increase intracranial pressure and compromise respiratory and circulatory status. Therefore, it is important to avoid this position.
Question 4.
Which of the following statements from the patient indicates that they understand the purpose of taking corticosteroids for increased intracranial pressure?
(a) "I'm taking corticosteroids to reduce my body temperature."
(b) "I'm taking corticosteroids to prevent seizures."
(c) "I'm taking corticosteroids to maintain my blood pressure."
(d) "I'm taking corticosteroids to decrease cerebral edema."
Answer:
(d) "I'm taking corticosteroids to decrease cerebral edema."
Explanation:
Corticosteroids are given to stabilize the cell membrane and reduce leakiness of the blood-brain barrier, which helps decrease cerebral edema. Option (a) is incorrect because antipyretics are used to prevent temperature elevations, not corticosteroids. Option (b) is incorrect because antiseizure medications are given prophylactically to prevent seizures. Option (c) is incorrect because blood pressure medication may be required to maintain cerebral perfusion, but not for taking corticosteroids.
Question 5.
Which of the following statements from the patient indicates that the unconscious client is experiencing dehydration?
(a) The client has edema in their legs
(b) The client has normal urinary output
(c) The client's skin is intact
(d) The client has not had anything to drink in the last 24 hours
Answer:
(d) The client has not had anything to drink in the last 24 hours
Explanation:
Dehydration occurs when there is a lack of fluid intake or excessive fluid loss, and one of the signs of dehydration is a decrease in urine output. Option (a) is incorrect because edema is a sign of fluid retention, not dehydration. Option (b) is incorrect because normal urinary output does not necessarily indicate hydration status. Option (c) is incorrect because intact skin does not provide any indication of hydration status. Option (d) is correct because the client not having anything to drink in the last 24 hours suggests that they may be dehydrated.
Question 6.
Which of the following statements from the patient indicates that they may have an epidural hematoma?
(a) "I have been experiencing headaches and dizziness since my fall."
(b) "My vision has been blurry since I hit my head."
(c) "I have a bump on my forehead where I hit my head."
(d) "I lost consciousness for a few minutes after I fell."
Answer:
(d) "I lost consciousness for a few minutes after I fell."
Explanation:
The passage describes that epidural hematoma is often associated with temporary loss of consciousness, followed by a lucid period that then rapidly progresses to coma. Therefore, a patient who has lost consciousness for a few minutes after a head injury is more likely to have an epidural hematoma than the other options.
Option (a) is incorrect because headaches and dizziness can be associated with many types of head injuries, not just epidural hematomas. Option (b) is incorrect because blurry vision is not specifically associated with epidural hematomas, and could be a symptom of other head injuries or conditions. Option (c) is incorrect because a bump on the forehead indicates a superficial injury and does not provide information about potential brain injury.
Question 7.
Which of the following statements from the patient indicates that they may have an epidural hematoma?
(a) "I hit my head really hard and felt dizzy for a few seconds.”
(b) "I have a headache and my vision is blurry."
(c) "I have a bruise on my forehead.”
(d) "I fell and hit my head, but I didn't lose consciousness."
(e) "I have a cut on my scalp that won't stop bleeding."
(f) "I feel nauseous and have been vomiting since I hit my head."
(g) "I can't remember what happened before I hit my head."
Answer:
(d) "I fell and hit my head, but I didn't lose consciousness."
(g) "I can't remember what happened before I hit my head."
Explanation:
Epidural hematoma is a serious type of head injury that can occur due to arterial bleeding between the dura and skull. It is often associated with temporary loss of consciousness, followed by a lucid period that then rapidly progresses to coma. Therefore, the correct statements from the patient that indicate the possibility of epidural hematoma are "I fell and hit my head, but I didn't lose consciousness" and "I can’t remember what happened before I hit my head."
These statements suggest that the patient may have had a lucid period after the injury, which is a common symptom of epidural hematoma.
Option (a) suggests a mild concussion, which may or may not involve loss of consciousness. Option (b) suggests a headache and blurry vision, which may indicate a contusion or subdural hematoma.
Option (c) suggests a contusion, which is a bruising type of injury to the brain tissue. Option (e) suggests a scalp injury, which may or may not be associated with a head injury. Option (f) suggests nausea and vomiting, which may indicate a concussion or other type of head injury.
Question 8.
A 32-year-old male is brought to the emergency department after a motor vehicle accident. He is conscious but confused and complains of a headache. The nurse performs a neurological assessment and notes that the patient has a small laceration on his forehead. The patient's vital signs are stable, but he reports feeling nauseous. A CT scan of the head is ordered and shows a small epidural hematoma.
Which of the following statements from the nurse indicates that she understands the severity of the patient's injury?
(a) "An epidural hematoma is a minor injury that will heal on its own."
(b) "The patient's symptoms are probably just a result of a mild concussion."
(c) "An epidural hematoma forms from bleeding between the brain and the skull."
(d) "Subdural hematoma forms rapidly and is a surgical emergency."
(e) "Intracerebral hemorrhage is a common injury from head trauma."
(f) "A subarachnoid hemorrhage only occurs spontaneously and is not related to trauma."
(g) "Epidural hematoma is the most serious type of hematoma and requires immediate surgical intervention."
Answer:
(g) "Epidural hematoma is the most serious type of hematoma and requires immediate surgical intervention."
Explanation:
(a) Incorrect. Epidural hematoma is a serious injury and should not be considered minor. It requires immediate medical attention and possibly surgery. (b) Incorrect. The patient’s symptoms, including confusion and nausea, are likely related to the epidural hematoma and not a mild concussion. (c) Incorrect. This statement is partially correct, but the nurse needs to understand the severity of this injury.
(d) Incorrect. Subdural hematoma forms slowly and is not the type of injury seen in this patient's CT scan. (e) Incorrect. Intracerebral hemorrhage is not the type of injury seen in this patient's CT scan. (f) Incorrect. A subarachnoid hemorrhage can occur as a result of head trauma and is not only spontaneous.
(g) Correct. The nurse correctly identifies that an epidural hematoma is the most serious type of hematoma and requires immediate surgical intervention. The patient's symptoms and CT scan findings indicate that he has this type of injury, and prompt medical attention is necessary to prevent further complications.
Question 9.
Mrs. Vimal, a 64-year-old female, has just undergone a craniotomy for a brain tumor. As the nurse responsible for her care, you are tasked with monitoring her postoperative status closely. You check on her every 30 to 60 minutes, monitor her vital signs, and assess her neurological status. You also check her head dressing frequently for signs of drainage and record the amount and color of any drainage from the drain every 8 hours.
Which of the following statements from the nurse indicates that she is providing appropriate nursing care following a craniotomy?
(a) "I will monitor the head dressing for signs of drainage every 4 hours."
(b) "I will measure the amount and color of drainage from the drain every 12 hours."
(c) "I will maintain fluid restriction at 2500 mL/day."
(d) "I will administer sedatives to promote sleep."
(e) "I will provide range-of-motion exercises every 12 hours."
(f) "I will monitor for dysrhythmias resulting from respiratory distress."
(g) "I will notify the HCP immediately of excessive amounts of drainage or a saturated head dressing."
Answer:
(g) "I will notify the HCP immediately of excessive amounts of drainage or a saturated head dressing."
(a) "I will monitor the head dressing for signs of drainage every 4 hours."
Explanation:
Option (a) is correct because monitoring the head dressing for signs of drainage is crucial to detect any possible complications such as infection. Checking every 4 hours would not be frequent enough to catch any changes in a timely manner. Option (g) is also correct because notifying the HCP immediately of excessive amounts of drainage or a saturated head dressing is essential to prevent further complications.
Option (b) is incorrect because measuring the amount and color of drainage from the drain every 12 hours is not frequent enough to detect any changes in a timely manner. Option (c) is incorrect because fluid restriction should be maintained at 1500 mL/day, not 2500 mL/day. Option (d) is incorrect because administering sedatives is not indicated following a craniotomy.
Option (e) is incorrect because range-of-motion exercises should be provided every 8 hours, not every 12 hours. Option (f) is incorrect because dysrhythmias resulting from respiratory distress are not commonly associated with a craniotomy; they may be caused by fluid or electrolyte imbalances.
Question 10.
A nurse is caring for a client with a spinal cord injury who develops autonomic dysreflexia. Which of the following statements said by the nurse indicates that they understand the appropriate management of this condition?
(a) "I will wait and see if the client's symptoms resolve on their own."
(b) "I will administer a stimulant laxative to help with constipation."
(c) "I will administer an antihypertensive medication immediately."
(d) "I will assess for bladder distention and remove any noxious stimuli."
(e) "I will check the client's oxygen saturation and provide supplemental oxygen if needed."
(f) "I will assess the client's skin for pressure ulcers."
(g) "I will turn the client to the side and elevate the legs to increase blood flow."
Answer:
(d) "I will assess for bladder distention and remove any noxious stimuli."
(g) "I will turn the client to the side and elevate the legs to increase blood flow."
Explanation:
Autonomic dysreflexia is a medical emergency that can occur in individuals with spinal cord injuries. It is characterized by severe hypertension, bradycardia, severe headache, nasal stuffiness, and flushing, and is typically caused by a noxious stimulus, such as bladder distention or constipation. The prompt removal of the noxious stimulus is crucial to prevent further complications, such as hypertensive stroke.
The correct answers are (d) and (g). The nurse should first assess for bladder distention and remove any noxious stimuli. If the client has a urinary catheter, the nurse should check for kinks in the tubing. Additionally, if the nurse suspects fecal impaction, they should disimpact the client if necessary. Option (a) is incorrect because waiting for the client's symptoms to resolve on their own could be dangerous and increase the risk of complications. Option (b) is incorrect because administering a stimulant laxative would not address the underlying cause of autonomic dysreflexia.
Option (c) is incorrect because administering an antihypertensive medication should only be done under the guidance of a healthcare provider. Option (e) is incorrect because checking the client's oxygen saturation and providing supplemental oxygen is not the first priority in managing autonomic dysreflexia. Option (f) is incorrect because assessing the client's skin for pressure ulcers is not relevant to managing autonomic dysreflexia. Option (g) is correct because turning the client to the side and elevating the legs can help to increase blood flow and prevent hypertensive stroke.
Question 11.
Mr. Vimal is a 38-year-old male with a spinal cord injury at the T6 level. He has a history of autonomic dysreflexia and has been instructed to report any symptoms immediately to his healthcare provider. One afternoon, Mr. Vimal complains of a severe headache, nasal stuffiness, and flushing. On assessment, the nurse notes that his blood pressure is 190/100 mmHg, and his heart rate is 56 beats per minute. Which of the following statements said by the patient indicates that he understands the management of autonomic dysreflexia?
(a) "I will take an antihypertensive medication if I feel dizzy."
(b) "I will lie flat in bed until the symptoms go away."
(c) "I will drink more fluids to flush out my system."
(d) "I will call my healthcare provider immediately if I experience these symptoms."
(e) "I will take pain medication to relieve the headache."
(f) "I will try to ignore the symptoms and hope they go away."
(g) "I will tighten my clothing to make me feel more comfortable."
Answer:
(d) "I will call my healthcare provider immediately if I experience these symptoms."
(a) "I will take an antihypertensive medication if I feel dizzy."
Explanation:
Autonomic dysreflexia is a serious and potentially life-threatening condition that can occur in individuals with spinal cord injury at or above the T6 level. It is caused by a noxious stimulus, usually bladder or bowel distension, which triggers a reflex response in the autonomic nervous system, leading to severe hypertension and bradycardia.
The patient's response "I will call my healthcare provider immediately if I experience these symptoms." indicates that he understands the importance of prompt medical attention in the event of an autonomic dysreflexia episode. This is a crucial step in managing the condition.
Additionally, the response "I will take an antihypertensive medication if I feel dizzy." is also correct. Antihypertensive medication may be prescribed by the healthcare provider to manage the severe hypertension that occurs with autonomic dysreflexia. If the patient feels dizzy, it may be an indication that the blood pressure is too low, and the medication may need to be adjusted.
The other options are incorrect because they either suggest inappropriate actions (e.g., lying flat in bed, tightening clothing, ignoring symptoms) or do not address the management of autonomic dysreflexia (e.g., drinking more fluids, taking pain medication).
Question 12.
A 25-year-old male patient presented to the emergency department with a history of seizures. He reported that he had been experiencing seizures for the past year. He described the seizures as involving a brief loss of consciousness, followed by jerking of his arms and legs. He reported that the seizures usually lasted about 30 seconds, and he often felt confused and disoriented afterward. He denied any recent head trauma or fever. On examination, the patient was found to be alert and oriented to person, place, and time. Vital signs were stable. Neurological examination was unremarkable. An electroencephalogram (EEG) was ordered, which revealed generalized spike and wave discharges consistent with a diagnosis of generalized epilepsy.
Which of the following statements said by the patient indicates that he is most likely experiencing tonic-clonic seizures?
(a) He experiences brief seizures that last seconds.
(b) He has a sudden momentary loss of muscle tone.
(c) He presents with sensory symptoms accompanied by motor symptoms.
(d) He experiences periods of altered behavior of which he is not aware.
(e) He appears to be daydreaming during the seizures.
(f) He experiences a brief generalized jerking or stiffening of extremities.
(g) He reports an aura before the seizure.
Answer:
(a) He experiences brief seizures that last seconds.
(f) He experiences a brief generalized jerking or stiffening of extremities.
Explanation:
Tonic-clonic seizures are characterized by a stiffening or rigidity of the muscles, followed by hyperventilation and jerking of the extremities. The patient in this case study reported experiencing jerking of his arms and legs, which is consistent with the clonic phase of a tonic-clonic seizure. Therefore, option (f) is correct.
Absence seizures are brief seizures that last seconds, and the individual may or may not lose consciousness.
This is not consistent wdth the patient's reported symptoms and is therefore incorrect. Therefore, option (a) is correct. Option (b) describes an atonic seizure, which is not consistent with the patient's reported symptoms and is therefore incorrect. Option (c) describes a simple partial seizure, which typically produces sensory symptoms accompanied by motor symptoms that are localized or confined to a specific area. This is not consistent with the patient's reported symptoms and is therefore incorrect.
Option (d) describes a complex partial seizure, which is characterized by periods of altered behavior of which the client is not aware. This is not consistent with the patient's reported symptoms and is therefore incorrect. Option (e) describes an absence seizure, which is more common in children and involves a brief loss of consciousness without any loss or change in muscle tone.
This is not consistent with the patient's reported symptoms and is therefore incorrect. Option (g) describes an aura, which is a warning sign that occurs before some seizures. The patient reported experiencing seizures without mentioning an aura, so this option is incorrect.
Question 13.
Which of the following statements said by the nurse indicates that the client with stroke is experiencing neglect syndrome?
(a) "The client is having difficulty recognizing familiar objects and persons."
(b) "The client has lost the ability to execute skilled movements despite having physical ability."
(c) "The client is experiencing blindness in half of the visual field."
(d) "The client has a loss of half of the field of view on the same side in both eyes."
(e) "The client has an altered position sense that places them at increased risk of injury."
(f) "The client must turn their head to scan the complete range of vision due to visual problems."
(g) "The client is aware of their paralyzed side and can move it voluntarily."
(h) "The client has no difficulty with recognizing objects or persons."
Answer:
(c) "The client is experiencing blindness in half of the visual field."
(d) "The client has a loss of half of the field of view on the same side in both eyes."
Explanation:
The statement "The client is experiencing blindness in half of the visual field" indicates that the client is experiencing hemianopsia or homonymous hemianopsia, which are common visual impairments associated with stroke. Neglect syndrome, also known as unilateral neglect, is a condition where the client is unaware of the existence of his or her paralyzed side. Thus, options (a), (b), (e), (f), (g), and (e) are incorrect. Option (d) also mentions a loss of half of the field of view on the same side in both eyes, which is another term for homonymous hemianopsia.
Question 14.
A 65-year-old male presents to the emergency department with sudden onset of weakness and numbness on the right side of his body. He is conscious and alert. The medical team suspects a stroke and orders a CT scan. The CT scan confirms the presence of a hemorrhagic stroke.
Which of the following statements said by the patient indicates that he may have experienced a hemorrhagic stroke?
(a) "I feel like I'm going to pass out."
(b) "My symptoms started getting worse gradually."
(c) "I have a severe headache."
(d) "My right side feels weak and numb."
(e) "I suddenly lost my ability to speak."
(f) "My symptoms started getting better on their own."
(g) "I feel dizzy and disoriented."
(h) "I can't remember what happened before the symptoms started."
Answer:
(c) "I have a severe headache."
(d) "My right side feels weak and numb."
Explanation:
Hemorrhagic stroke is characterized by a sudden onset of symptoms, which progress over minutes to hours due to ongoing bleeding. Therefore, the patient's statement about having a severe headache is a warning sign of a hemorrhagic stroke. In addition, the patient's statement about weakness and numbness on the right side of his body is also consistent with a hemorrhagic stroke.
Option (a) is incorrect because feeling like passing out is more typical of an ischemic stroke, not a hemorrhagic stroke. Option (b) is incorrect because gradual worsening of symptoms is not typical of a hemorrhagic stroke. Option (e) is incorrect because sudden loss of ability to speak is more typical of an ischemic stroke, not a hemorrhagic stroke.
Option (f) is incorrect because spontaneous improvement of symptoms is not typical of a hemorrhagic stroke. Option (g) is incorrect because feeling dizzy and disoriented is a non-specific symptom and can occur in both hemorrhagic and ischemic strokes. Therefore, options (c) and (d) are the most likely indicators of a hemorrhagic stroke.
A 65-year-old male patient presents to the emergency room with sudden onset of right-sided weakness and slurred speech. The patient denies any history of head trauma or seizures. He has a past medical history of hypertension, dyslipidemia, and diabetes mellitus. Upon examination, the patient is alert but has right-sided hemiparesis and facial droop. His blood pressure is elevated at 160/100 mmHg. A CT scan of the head shows a left middle cerebral artery infarct.
Question 15.
Which of the following statements said by the patient indicates that he may have suffered from a thrombotic stroke?
(a) "I had a sudden onset of symptoms"
(b) "I have a headache"
(c) "I feel like my symptoms are getting worse"
(d) "I feel like I'm going to pass out"
(e) "I've had this before and it w'ent away on its own"
(f) "I was feeling fine until this happened"
(g) "I'm not sure what's happening to me"
(h) "I think I might have hit my head earlier"
Answer:
(c) "I feel like my symptoms are getting worse"
(f) "I was feeling fine until this happened"
Explanation:
Thrombotic strokes typically have a gradual onset of symptoms, and the patient may not experience a decreased level of consciousness within the first 24 hours. Symptoms can get progressively worse as the infarction and edema increase, as indicated by option (c). Option F indicates that the patient was feeling fine before the onset of symptoms, which is also suggestive of a thrombotic stroke. The other options are not indicative of a thrombotic stroke.
Option (a) is suggestive of a hemorrhagic stroke, as sudden onset of symptoms is more common in this type of stroke. Option (b) is suggestive of an embolic stroke, as headache is a warning sign that may be present in this type of stroke. Option (d) is not indicative of any type of stroke. Option (e) may suggest a transient ischemic attack (TIA), but the patient's symptoms are more consistent with a stroke. Option (g) is also not indicative of any type of stroke. Finally, option (h) suggests head trauma, which is not consistent with a thrombotic stroke.
Question 16.
Which of the following statements said by the patient indicates that they may be experiencing Bell's Palsy?
(a) "I have been experiencing a gradual progressive weakness of my lower extremities and facial muscles."
(b) "I have been having paresthesias and hypersensitivity to touch."
(c) "I have been experiencing pain in my upper body and have an abnormal electroencephalogram."
(d) "I have been having difficulty breathing and my respiratory status is being closely monitored."
(e) "I have an elevated protein level in my CSF."
(f) "I am experiencing weakness and paralysis on one side of my face."
(g) "I am having difficulty chewing and have lost taste sensation."
Answer:
(f) "I am experiencing weakness and paralysis on one side of my face."
(g) "I am having difficulty chewing and have lost taste sensation."
Explanation:
Bell's Palsy is characterized by paralysis of one side of the face, as well as loss of taste. Option (a) describes weakness of lower extremities, which is not characteristic of Bell's Palsy. Option (b) describes paresthesias and hypersensitivity to touch, which may be indicative of Guillain-Barre Syndrome. Option (c) describes pain and an abnormal electroencephalogram, which may be indicative of other neurological conditions.
Option (d) describes difficulty breathing, which is a major concern in Guillain-Barre Syndrome. Option (e) describes an elevated protein level in the CSF, which may be indicative of various neurological conditions. Therefore, options F and G are the correct answers as they are the only statements that describe symptoms characteristic of Bell's Palsy.
Question 17.
Which of the following statements from the patient indicates that they may have meningitis?
(a) The patient has a cough and runny nose
(b) The patient has a mild headache
(c) The patient has a fever and a red, macular rash
(d) The patient is experiencing abdominal pain
(e) The patient has been taking antibiotics for a sinus infection
(f) The patient has a positive reaction to Kernig's sign and Brudzinski's sign
(g) The patient has a history of high blood pressure
Answer:
(f) The patient has a positive reaction to Kernig's sign and Brudzinski's sign
(c) The patient has a fever and a red, macular rash
Explanation:
(a) This option suggests symptoms of a common cold or flu and is not indicative of meningitis. Option (b) A mild headache is a common symptom and not specific to meningitis. Option (c) A fever and a red, macular rash are signs of meningococcal meningitis, making this option correct.
Option (d) Abdominal pain is not a specific symptom of meningitis and is not included in the assessment findings. (e) The use of antibiotics for a sinus infection suggests a bacterial infection, but it is not specific to meningitis. (f) A positive reaction to Kernig's sign and Brudzinski's sign are classic signs of meningeal irritation, indicating possible meningitis. (g) A history of high blood pressure is not related to meningitis.
Question 18.
Saigrace is a 25-year-old male who presents to the emergency department with a fever, headache, and neck stiffness. He reports feeling lethargic and having difficulty with bright lights. Upon examination, Kernig's sign and Brudzinski's sign are positive. A lumbar puncture is performed, and the CSF analysis shows cloudy fluid with increased protein, increased white blood cells, and decreased glucose counts. Based on these findings, Saigrace is diagnosed with meningitis.
Which of the following statements of the patient indicates that Saigrace has meningitis?
(a) Saigrace reports feeling lethargic.
(b) Saigrace has positive Kernig's sign and Brudzinski's sign.
(c) Saigrace has a red, macular rash.
(d) Saigrace complains of abdominal pain.
(e) Saigrace has a chest pain.
(f) Saigrace has a history of sinus infections.
(g) Saigrace has a compromised immune system.
Answer:
(b) Saigrace has positive Kernig's sign and Brudzinski's sign.
(g) Saigrace has a compromised immune system.
Explanation:
Option (b) Saigrace having positive Kernig's sign and Brudzinski's sign indicates meningeal irritation, which is a characteristic sign of meningitis.
Option (g) Saigrace having a compromised immune system is a predisposing factor for meningitis.
Option (a) is incorrect because lethargy is a common symptom in many conditions and is not specific to meningitis. Option (c) is incorrect because a red, macular rash is a sign of meningococcal meningitis, which is a specific type of meningitis and not present in all cases.
Option (d) and (e) are incorrect because abdominal and chest pain are not characteristic signs of meningitis. Option (f) is incorrect because a history of sinus infections is a predisposing factor, but not a definitive indicator, of meningitis.
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